At the heart of the Community Medical Health Center (CMHC) program has been the goal of enhanced delivery of services to the poor and minority groups with impaired access to traditional services. The program has been criticized for failure in this regard. Yet some centers have been successful in carrying out this mandate. The Metropolitan Hospital CMHC in New York City is regarded as one of these. Our aim is to evaluate the basis for this apparent success with an eye to making policy recommendations for improved services for these groups. Specifically, we address three issues: (1) What center and client factors attract the poor, blacks and Puerto Ricans to Metropolitan's services? (2) Have recent changes in reimbursement policies had an impact? (3) Do class and ethnic factors influence diagnoses and allocations to treatment modalities (once clients enter the program)? The effects on utilization of geographic accessibility, staff characteristics, patient attitudes and cost of services will be examined. This part of the analysis will depend mainly on interviews of 450 former patients. The impact of reimbursement policies will be studied by comparing patient characteristics before and after the changes. These data will be obtained from sampling patient records. These dockets will also help study diagnostic and treatment differentials. The effects of class and ethnic traits will be gauged via multiple regression analysis. We will ask whether these attributes and not just symptoms account for a significant portion of the variance here -- and if so, how much.